| NPI | 1073170908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.018519) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178018519) |
| 102L00000X Psychoanalyst (Licence: IL 12022942) | |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2026-04-01 |